Hypoglossal Nerve Stimulation for the Treatment of Obstructive Sleep Apnea

FDA-approved hypoglossal nerve stimulation is covered for adults (age ≥22) with moderate-to-severe OSA (AHI 15–65) who have BMI <35, predominantly obstructive events (<25% central/mixed), a PSG within 24 months, documented CPAP failure or intolerance with shared decision making, absence of complete concentric collapse on DISE, and no anatomical findings that would compromise device performance. Coverage is excluded for non‑FDA devices and for beneficiaries with specified contraindications (e.g., BMI ≥35, neuromuscular disease, hypoglossal palsy, significant cardiac or pulmonary disease, pregnancy, inability to operate the remote, central/mixed apneas >25%, or other listed conditions); detailed DISE, training, and shared-decision documentation must be retained for review.

"Beneficiary is 22 years of age or older."

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